In utero transfers across yorkshire and the humber by embrace transport service. (7th June 2011) - Babarao, S
Abstract : Embrace, combined paediatric and neonatal transport service for Yorkshire and Humber, is also a cot locator to facilitate in-utero transfers for a region with 75 000 births/year. Aims: To evaluate in utero transfer requests – indications for transfer, time spent locating cot/bed, fibronectin use and outcomes. Prospective audit of all in-utero requests 1 October 2010–7 January 2011. Data obtained via audit proforma and phone calls to maternity units. Results: 120 in-utero transfers requested. Reasons for requests: ▶ lack of neonatal cots 54% (65/120). ▶ maternal conditions requiring specialist care 2.5% (3/120). ▶ preterm gestation 24% (29/120). ▶ impending preterm labour 7.5% (9/120). 86 transfers facilitated resulting in mother being transferred for care. 13/120 of total requests – out of region cot located. 34 did not result in transfer despite cot/bed being located by Embrace. Reasons: ▶ Mother deteriorated/went into labour 41% (14/34). ▶ Unit unwilling to accept out of region cot 12% (4/34). ▶ Local NNU arranged cot 15% (5/34). ▶ Referring hospital arranged transfer 6% (2/34). ▶ Changed decision re transfer need 20.7% (7/34). Tertiary perinatal centres accepted 41% transfers, level 2 units 59%. Mean time facilitating transfers – 82 min. Mean number of phone calls – 6.3. On average to organise 1 successful IUT, 2.1 maternity units and 3.4 neonatal units contacted. 50% of mothers delivered within 24 h of transfer. No reported fetal /maternal morbidity following transfer. 13.3% referrals used fibronectin. Conclusion: IUT are a significant part of Embrace's workload. Enhanced use of fibronectin may enhance appropriateness of transfers.